Cell wall synthesis- individual facts

Question 1

Mechanism of action of all penicillins

Answer 1

Binds penicillin binding protein and inhibits transpeptidase action

Question 2

Spectrum of penicillin

Answer 2

Gram+, some Gram-

Question 3

Co drug treated with penicillin

Answer 3

Probenecid

Question 4

Side effects of penicillin

Answer 4

Hypersensitivity, mild rash, anaphylaxis, seizure, nausea, diarrhea

Question 5

Name Penicillinase-resistant penicillins

Answer 5

Nafcillin, Dicloxacillin, Antistaph penicillins

Question 6

Reason why Nafcillin and Dicloxacillin are resistant to penicillinases

Answer 6

They have a larger R group

Question 7

Spectrum of penicillinase-resistant penicillins

Answer 7

Very narrow, MSSA

Question 8

Beta-lactamase inhibitors

Answer 8

Clavulanate, Sulbactam, Tazobactam

Question 9

Amino-penicillins

Answer 9

Ampicillin, Amoxicillin

Question 10

Mechanism of aminopenicillins

Answer 10

Water soluble can pass through porins, bind to PBPs

Question 11

Spectrum of aminopenicillins

Answer 11

Gram+, Gram-, wide spectrum

Question 12

Co drugs for aminopenicillins

Answer 12

Amoxicillin/clavulanate, Ampicillin/sulbactam

Question 13

Side effects of aminopenicillins

Answer 13

Hypersensitivity, ampicillin can cause pseudomembranous colitis

Question 14

Resistance of aminopenicillins

Answer 14

Beta-lactamases

Question 15

Anti-pseudomonal penicillins

Answer 15

Ticarcillin, piperacillin

Question 16

Spectrum of anti-pseudomonal penicillins

Answer 16

Gram+, Gram-, mostly used to treat pseudomonas

Question 17

Co-drugs for anti-pseudomonal penicillins

Answer 17

Ticarcillin/clavulanate, pipercillin/tazobactam

Question 18

Resistance of anti-pseudomonal penicillins

Answer 18

Penicillinase-susceptible

Question 19

Monobactam drug

Answer 19

Aztreonam

Question 20

Mechanism of action for monobactams

Aztreonam

Answer 20

Monocyclic beta-lactam, binds PBP

Question 21

Spectrum of monobactams

Aztreonam

Answer 21

Gram-, Klebsiella, pseudomonas, serratia

Question 22

Co-drugs for monobactams

Aztreonam

Answer 22

Beta-lactamase inhibitors

Question 23

Resistance to monobactams

Aztreonam

Answer 23

Extended spectrum beta-lactamase

Question 24

Concerns for cephalosporins

Answer 24

Excreted by kidney, watch for renal insufficiency. Cross hypersensitive with penicillin.

Question 25

Resistance to Cepaholosporins

Answer 25

Extended spectrum beta-lactamases

Question 26

Use for 1st gen cephalosporin (Cephalexin)

Answer 26

Surgical prophylaxis

Question 27

Spectrum for 1st gen ceph

Answer 27

Gram+

Question 28

Use for 2nd gen cep (cefoxitin)

Answer 28

Immediately prior to surgery

Question 29

Spectrum of 2nd gen ceph

Answer 29

Gram-, weak against Gram+

Question 30

Concerns for 2nd gen ceph

Answer 30

Can inhibit Vit K production (increases bleeding)

Question 31

Spectrum for 3rd gen ceph

Answer 31

Strep, serious Gram-, meningitis

Question 32

Notes about 3rd gen ceph

Answer 32

Can cross the BBB, used to treat meningitis

Question 33

Side effects of 2nd gen ceph

Answer 33

Can create disulfiram-like rxn with EtOH

Question 34

Side effects of 3rd gen ceph

Answer 34

Can interact w/ Calcium to form crystals in lungs and kidneys

Question 35

Spectrum of 4th gen ceph

Answer 35

very broad, Gram+/-, pseudomonas

Question 36

Mechanism of action for 5th gen ceph

Answer 36

Binds to PBP 2a present in MRSA

Question 37

Spectrum for 5th gen ceph

Answer 37

MRSA, CABP, ABSSSI

Question 38

Carbapenems

Answer 38

Imipene, meropenem

Question 39

Spectrum of carbapenems | Imipene, meropenem

Answer 39

Broad, not MRSA

Question 40

Co drugs with carbapanems (and why) | Imipene, meropenem

Answer 40

Imipene/Cilistatin, prevents break down into toxic metabolite in vivo

Question 41

Side effects of carbapenems | Imipene, meropenem

Answer 41

GI distress, seizures if renal dysfuntion

Question 42

Resistance to carbapenems | Imipene, meropenem

Answer 42

Change in PBP, low susceptibility to beta-lactamase

Question 43

Mechanism of action of vancomycin

Answer 43

Binds to DADA terminus of cell wall precursor, inhibiting release from bactoprenol carrier. Inhibits transglycosylase reaction

Question 44

Spectrum of vancomycin

Answer 44

Gram+, MRSA, C. Diff

Question 45

Side effects of vancomycin

Answer 45

Red man syndrom, nephrotoxicity

Question 46

Resistance to vancomycin

Answer 46

Enterococci replace amino acids on terminus to prevent binding

Question 47

Use of bacitracin

Answer 47

topical and ophthalmic derm preps

Question 48

Mechanism of action of bacitracin

Answer 48

Prevents dephosphorylation of bactoprenel (wall elongation)

Question 49

Side effects of IM bacitracin

Answer 49

Nephrotoxic

Question 50

Resistance to bacitracin

Answer 50

Very rare

Question 51

Mechanism of action of Polymyxin B

Answer 51

Binds to LPS to create holes and facilitate entry

Question 52

Spectrum of polymyxin B

Answer 52

Gram-, pseudomonas, klebsiella

Question 53

resistance to polymyxin B

Answer 53

Infreqent/slow

Question 54

Mechanism of daptomycin

Answer 54

Binds to cell membrane and aggregates, depolarizing cell wall

Question 55

Spectrum of daptomycin

Answer 55

Gram+, MRSA

Question 56

Resistance to daptomycin

Answer 56

Addition of lysin to cell surface (repels + charge of drug)

Question 57

Treatment of C. difficile

Answer 57

Vancomycin, Metromidzole, Fidaxomicin

Question 58

Treatment of MRSA

Answer 58

Vancomycin, Daptomycin